Next Article in Journal
Probiotic Lactobacillus spp. Act Against Helicobacter pylori-induced Inflammation
Previous Article in Journal
MicroRNA Cross-Involvement in Autism Spectrum Disorders and Atopic Dermatitis: A Literature Review
Article Menu

Export Article

Open AccessArticle
J. Clin. Med. 2019, 8(1), 89; https://doi.org/10.3390/jcm8010089

Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing

1
Clinical Research Centre, Copenhagen University Hospital, 2650 Hvidovre, Denmark
2
Section of Pharmacotherapy, Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
3
The Capital Regional Pharmacy, 2730 Herlev, Denmark
4
Center for Clinical Research and Prevention, Copenhagen University Hospital, 2000 Frederiksberg, Denmark
5
Department of Orthopaedic Surgery, Copenhagen University Hospital, 2650 Hvidovre, Denmark
6
Emergency Department, Copenhagen University Hospital, 2650 Hvidovre, Denmark
7
Section of Biostatistics, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
*
Author to whom correspondence should be addressed.
Received: 1 December 2018 / Revised: 3 January 2019 / Accepted: 9 January 2019 / Published: 14 January 2019
(This article belongs to the Section Nephrology & Urology)
Full-Text   |   PDF [465 KB, uploaded 14 January 2019]   |  
  |   Review Reports

Abstract

Accurate kidney function estimates are necessary when prescribing renally-eliminated medications. Our objectives were to investigate how amputation affects estimated glomerular filtration rate (eGFR) and to determine if dosing recommendations differ among different eGFR equations. In a cohort study of non-traumatic amputation patients, eGFR based on creatinine and/or cystatin C were measured before and after amputation. Prescribed, renally-eliminated medications were compared with dosing guidelines in Renbase®. Data from 38 patients with a median age of 75 years were analyzed. The median (range) eGFR was 65 (15–103), 38 (13–79), and 48 (13–86) mL/min/1.73 m2 before amputation and 80 (22–107), 51 (13–95), and 62 (16–100) mL/min/1.73 m2 after amputation for eGFRCreatinine, eGFRCystatinC, and eGFRCombined, respectively (p < 0.01). From before to after amputation, eGFR increased on average by 8.5, 6.1, and 7.4 mL/min/1.73 m2 for eGFRCreatinine, eGFRCystatinC, and eGFRCombined (all p < 0.01), respectively. At least one renally-eliminated medication was prescribed at a higher dose than recommended in 37.8% of patients using eGFRCystatinC, 17.6% using eGFRCombined and 10.8% using eGFRCreatinine. In conclusion, amputation affects eGFR regardless of the eGFR equations. The differences among equations would impact prescribing of renally-eliminated medications, particularly when switching from creatinine to cystatin C. View Full-Text
Keywords: Creatinine; cystatin C; glomerular filtration rate; renal insufficiency; amputation; drug therapy; drug dose adjustment; drug dosing; inappropriate prescribing Creatinine; cystatin C; glomerular filtration rate; renal insufficiency; amputation; drug therapy; drug dose adjustment; drug dosing; inappropriate prescribing
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Aakjær, M.; Houlind, M.B.; Treldal, C.; Ankarfeldt, M.Z.; S. Jensen, P.; Andersen, O.; Iversen, E.; Christrup, L.L.; Petersen, J. Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing. J. Clin. Med. 2019, 8, 89.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top